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Updated: Dec 28, 2025

Whole Genome Sequencing of Candida glabrata for Detection of Markers of Antifungal Drug Resistance
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Whole Genome Sequencing of Candida glabrata for Detection of Markers of Antifungal Drug Resistance

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Drug resistance and tolerance in fungi

Judith Berman1, Damian J Krysan2

  • 1School of Molecular Cell Biology & Biotechnology, George S. Wise Faculty of Life Sciences, Tel Aviv University, Ramat Aviv, Israel. berma003@umn.edu.

Nature Reviews. Microbiology
|February 13, 2020
PubMed

Insights

Antifungal drug tolerance, not just resistance, may explain why some systemic fungal infections don't respond to treatment. Understanding tolerance mechanisms is key to improving patient outcomes.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Pharmacology

Background:

  • Systemic fungal infections present significant clinical challenges.
  • Limited antifungal treatment options and increasing drug resistance exacerbate the problem.
  • Many patients fail therapy despite susceptible fungal pathogens.

Purpose of the Study:

  • To define and differentiate antifungal drug resistance and tolerance.
  • To review the molecular, genetic, and physiological mechanisms underlying these phenomena.
  • To explore the clinical implications of distinguishing tolerance from resistance.

Main Methods:

  • Literature review of antifungal drug resistance and tolerance.
  • Analysis of molecular, genetic, and physiological mechanisms.
  • Synthesis of current understanding of fungal drug response.

Main Results:

  • Antifungal drug tolerance is a distinct phenomenon from resistance.
  • Tolerance contributes to treatment failure in systemic fungal infections.
  • Mechanisms of tolerance are multifaceted, involving various biological pathways.

Conclusions:

  • Distinguishing antifungal tolerance from resistance is crucial for understanding treatment failures.
  • Further research into tolerance mechanisms may reveal new therapeutic strategies.
  • Addressing tolerance could improve clinical outcomes for systemic fungal infections.

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